Ingabe uzizwa unesizungu ngokuzumayo, isifuba sakho siyashaya, amehlo akho aluhlaza okwesibhakabhaka, futhi uzizwa sengathi usuzoquleka? Ngezinye izikhathi lokhu kungaba uphawu lwesigqi senhliziyo esiyingozi. Namuhla sikhuluma ngesimo esingavamile kodwa esingaba yingozi. Sibizwa ngokuthi i-Torsades de Pointes (igama lesiFulentshi, elibizwa ngokuthi "torsades de pointes"). Igama lingase lizwakale lingavamile, kodwa kubalulekile ukwazi ukuthi lisho ukuthini nokuthi lingenzani.
Kalula nje, iyini i-Torsades de Pointes?
Lokhu kuyisigqi senhliziyo esisheshayo, esingavamile, nesiyingozi esiqala emakamelweni amabili aphansi enhliziyo yakho (ama-ventricles). Ukuze kube sobala, lolu uhlobo olukhethekile lokushaya kwenhliziyo okusheshayo (i-Ventricular Tachycardia). Ngokuvamile, ukushaya kwenhliziyo komuntu ophilile kuphakathi kwama-beats angu-60 no-100 ngomzuzu. Kodwa-ke, uma lesi simo senzeka, ukushaya kwenhliziyo kunganda kufike kuma-beats angu-150 kuya kwangu-300 ngomzuzu .
Lokhu kuyingozi ngoba kungenzeka ukuthi umuntu afe ngokuzumayo ngenxa yesifo senhliziyo ngaphandle kwesixwayiso .
Uma ubheka i-EKG yakho (i-electrocardiogram), kunephethini ethile odokotela abayibona kulesi simo. Kuyiphethini yamagagasi ajikajika emuva naphambili, njenge-coil. Igama lesiFulentshi elithi "Torsades de Pointes" lisho "ukujika kwamaphuzu." Lithola igama lalo ngenxa yokujikajika kwe-EKG.
Lesi simo sivame ukwenzeka kanye nenkinga ethile emsebenzini kagesi wenhliziyo. Sibizwa ngokuthi isikhawu eside se-QT. Kalula nje, isikhawu se-QT yisikhathi esithathayo ukuthi amakamelo aphansi enhliziyo yakho ashaye kanye bese ulungiselela ukushaya okulandelayo. Uma lesi sikhathi side ngendlela engavamile (i-QT ende), ukushaya okwengeziwe kungenzeka, okubangela i-Torsades de Pointes.
Ziyini izimpawu zalesi simo?
Into eyesabekayo lapha ukuthi ingxenye yabantu abanalesi simo ayinazo izimpawu . Labo ababhekana nalezi zimpawu bangase babe nalokhu okulandelayo. Kufanele uqaphele kakhulu ngalokhu.
| Isibonakaliso | Incazelo elula |
|---|---|
| Isiyezi | Kwenzeka lapho inhliziyo ingapompi igazi kahle, okuholela ekunciphiseni ukunikezwa kwegazi ebuchosheni. |
| Ukushaya kwenhliziyo | Uqala ukuzwa inhliziyo yakho ishaya ngokushesha noma ngokungajwayelekile. |
| Ubuhlanya | Ngizizwa sengathi sengizolahlekelwa ingqondo. |
| Ukuquleka | Kungabangelwa ukuphazamiseka kwesikhashana kokunikezwa kwegazi ebuchosheni. |
| Ukuboshwa kwenhliziyo | Lesi yisimo esiyingozi kakhulu. Inhliziyo iyayeka ukushaya ngokuzumayo. |
Kungani lokhu kwenzeka? Yiziphi izizathu?
Kunezinhlobo ezimbili eziyinhloko zezizathu zalokhu.
1. Izimbangela zokuzalwa: Abanye abantu bazalwa benesimo sofuzo esibizwa ngokuthi 'i-Long QT Syndrome'. Lokhu kusho ukuthi banalesi simo emndenini wabo. Laba bantu basengozini enkulu yokuthola i-Torsades de Pointes.
2. Izimbangela zakamuva: Lena yiyona evame kakhulu. 'Isikhathi se-QT' singandiswa ngokusebenzisa imithi ethile kanye namazinga e-electrolyte anciphile emzimbeni. Lokhu kwandisa ingozi ye-Torsades de Pointes.
Imithi eyandisa ingozi:
- Eminye imithi elawula isigqi senhliziyo (i-Antiarrhythmics)
- Amanye ama-antibiotic
- Eminye imithi yokuhlanza (i-Antiemetics)
- Imithi yokulwa nesikhunta
- Ama-antipsychotics imithi esetshenziselwa ukwelapha izifo ezithile zengqondo.
- Eminye imithi yokwelapha umdlavuza
Okubalulekile: Uma uthatha lolu hlobo lwemithi, ungesabi. Akuwona wonke umuntu ozobhekana nalesi simo. Kodwa kubaluleke kakhulu ukukhuluma nodokotela wakho ngalokhu futhi uqaphele izingozi.
Yiziphi izinto ezibangela lokhu?
Abanye abantu banamathuba amaningi okuthola lesi simo. Lezi zici eziyingozi yilezi:
- Ukuba nesimo esibizwa ngokuthi 'i-Long QT Syndrome'.
- Ukuba nezinye izifo zenhliziyo.
- Ukuba ngowesifazane (abesifazane basengozini enkulu)
- Ukuba neminyaka engaphezu kwengu -65 ubudala.
- I-thyroid engasebenzi kahle.
- Njengoba ehlaselwe yisifo sohlangothi.
- Ukusetshenziswa kwezidakamizwa zokuhlanza.
- Isilinganiso senhliziyo esihamba kancane (i-Bradycardia).
- Amazinga aphansi e -calcium, i-magnesium, noma i-potassium emzimbeni.
- Uhudo oluningi noma ukuhlanza.
Ingabe ingozi ingancishiswa?
Yebo, ungakwenza nakanjani. Kunezinto ezimbalwa ongazenza:
- Uma othile emndenini wakho ene-'Long QT Syndrome', zihlolele yona. Uma unayo, bonana nodokotela wenhliziyo ngaphambi kokuqala uhlelo lokuzivocavoca.
- Qaphela imithi oyithathayo: Uma uthatha umuthi ongandisa isikhathi 'se-QT', buza udokotela wakho ukuthi ungawuthatha yini omunye umuthi esikhundleni salokho. Uma uqala umuthi omusha, cela udokotela wakho ukuthi aqinisekise ukuthi ngeke ubangele izinkinga ngemithi oyithathayo njengamanje.
- Cabanga ngokudla okunempilo: Uma udokotela wakho ekuncoma, khulisa amazinga akho e-calcium, i-magnesium, kanye ne-potassium.
- Thatha imithi yakho ngesikhathi: Ukuze uvimbele lesi simo ukuthi singaphinde sivele, sebenzisa imithi njengoba nje udokotela wakho ekuyalele.
- Phuza amanzi amaningi: Gcina amazinga afanele amanzi nosawoti emzimbeni.
- Yazi izinga lokushaya kwenhliziyo yakho: Funda ukuthi liyini izinga lokushaya kwenhliziyo elivamile nokuthi ungalilinganisa kanjani.
- Uma unikezwe i-heart monitor: Uma udokotela wakho ekunike i-heart monitor ukuze uyigqoke ekhaya, qiniseka ukuthi uyayigqoka.
Kwenziwa kanjani ukuxilongwa?
Indlela eyinhloko yokuxilonga lokhu iwukuhlola i -`EKG` (i-Electrocardiogram) . Odokotela bangakubona lokhu ngokubheka iphethini ehlukile `esontekile` kanye ne-`QT interval` ende ebonakala ku-`EKG`.
Ngaphezu kwalokho, lezi zivivinyo zingenziwa futhi:
- Ukuhlolwa kwegazi: Hlola amazinga e-electrolyte emzimbeni, njenge-magnesium ne-potassium.
- I-Echocardiogram: Iskeni sokubheka isakhiwo kanye nomsebenzi wenhliziyo.
- I-Heart Monitor: Idivayisi egqokwa izinsuku eziningana futhi eqapha njalo isigqi senhliziyo.
Iphathwa kanjani?
Ukwelashwa kuncike embangela yalesi simo. Umuntu onesifo se-Long QT Syndrome azalwa naso uzodinga ukwelashwa isikhathi eside kunomuntu onesifo esibangelwa izidakamizwa.
| Uhlobo lokwelashwa | Incazelo |
|---|---|
| Imithi | |
| Ukuyeka imithi ebangela inkinga | Into yokuqala ukuthi udokotela ayeke umuthi acabanga ukuthi ubangela lokhu. |
| I-Magnesium kanye/noma i-potassium | Uma amazinga alawa sawoti emzimbeni ephansi, anikezwa ngemithambo yegazi ukuze abuyiselwe esimweni sawo esijwayelekile. |
| Ama-Beta-blocker | Inikezwa ukulawula izinga lokushaya kwenhliziyo kanye nalabo abane-'Long QT Syndrome'. |
| Ezinye izindlela namadivayisi (Izinqubo) | |
| I-Pacemaker | Kulabo abanezinga eliphansi kakhulu lenhliziyo, kufakwa ithuluzi elincane ukuze lihlale lisebenza kahle. |
| I-ICD (I-Implantable Cardioverter Defibrillator) | Lokhu futhi kuyithuluzi elifakwa emzimbeni. Uma libona isigqi senhliziyo esiyingozi, liletha ngokuzenzakalelayo ukushaqeka kukagesi ukuze kubuyiselwe inhliziyo esimeni sayo esijwayelekile. |
| Ukuguqulwa Kwenhliziyo Kagesi/Ukunciphisa Ukushisa Kwenhliziyo | Esimweni esiphuthumayo, ukushaqeka ngogesi esifubeni ukuze kubuyiselwe isigqi senhliziyo esijwayelekile. |
Kufanele ngimbone nini udokotela?
Uma uzwa izimpawu ezifana nokushaya kwenhliziyo okusheshayo, ubuhlungu besifuba, isiyezi, amehlo aluhlaza okwesibhakabhaka, noma ukulahlekelwa ukwazi, hamba uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela ngokushesha. Lesi yisimo esiphuthumayo.
Uma kufanele uhlale esibhedlela ngenxa yeTorsades de Pointes, kufanele nakanjani uye ekhaya ukuze uhlolwe emasontweni amabili. Njengoba lesi kuyisimo esinobungozi bokufa ngokuzumayo, kubalulekile ukuthi uhlale uqashwe njalo udokotela wenhliziyo.
Ungabuza udokotela wakho le mibuzo:
- Ingabe ngizalwa ngine-Long QT Syndrome, noma ibangelwa imithi?
- Yimaphi amathuba okuthi lesi simo sizokwenzeka nakwabanye abantu emndenini wami?
- Ingabe ukhona omunye umuthi engingawuthatha esikhundleni salowo obangele le ngozi?
Ngokwelashwa, lesi simo singalawulwa futhi ungaphila impilo enhle. Kodwa-ke, uma singelashwa, singaba yingozi. Ngakho-ke, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo bese uya emitholampilo ngezinsuku ezihleliwe.
Umlayezo Wokuya Nawe Ekhaya
- I-Torsades de Pointes iyisigqi senhliziyo esisheshayo kakhulu nesisongela impilo.
- Lokhu kungase kubangelwe yisimo sofuzo (i-Long QT Syndrome) noma imithi ethile kanye nokuntuleka kosawoti emzimbeni.
- Uma unezimpawu ezifana nobuhlungu besifuba obungazelelwe, isiyezi, noma ukulahlekelwa ukwazi, kuyisimo esiphuthumayo. Yiya e -ETU (Emergency Treatment Unit) ngokushesha.
- Ungalokothi uyeke ukuthatha imithi noma ushintshe umthamo ngaphandle kweseluleko sikadokotela wakho.
- Uma lesi simo sitholakala, ukwelashwa okuvamile kanye nokulandelela ngaphansi kukadokotela wenhliziyo kubalulekile.
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